Provider Demographics
NPI:1497930929
Name:ANDREA R RINKER DPM PC
Entity Type:Organization
Organization Name:ANDREA R RINKER DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:R
Authorized Official - Last Name:RINKER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:734-241-1222
Mailing Address - Street 1:721 N MACOMB ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-2982
Mailing Address - Country:US
Mailing Address - Phone:734-241-1222
Mailing Address - Fax:734-241-6825
Practice Address - Street 1:721 N MACOMB ST
Practice Address - Street 2:SUITE 5
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-2982
Practice Address - Country:US
Practice Address - Phone:734-241-1222
Practice Address - Fax:734-241-6825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901000949213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0686210001Medicare NSC